The midface and nasal bones have a significant influence on facial esthetics. Being able to predict the ultimate size of a growing patient's nose may influence the orthodontic treatment plan. Our study aimed to determine whether significant heritability exists between parents and children using multiple soft and hard tissue measurements of nasal dimensions.This cross-sectional study comprised 47 Western European families from the Forsyth Moorrees Twin Study. The lateral cephalograms of each parent and postpubertal child were evaluated using 14 cephalometric variables. The resemblance and heritability patterns were estimated from the Pearson correlation coefficient and Falconer's heritability test (ie, h2 = 2 × β estimate).We found significant heritability between 1 or both parents to sons, daughters, or both children for 11 measurements. Daughters were more strongly influenced by their mothers than fathers, and sons showed relatively few features strongly heritable from either parent. The nasal bone length and ANB were strongly heritable with the mother, and the nose length alone was strongly heritable with the father. In addition, 4 of the 6 measurements that were significantly heritable for daughters were horizontal measurements.Many nasal dimensions are significantly heritable. However, fathers more strongly influenced their daughters than sons, but mothers and daughters shared stronger and more numerous traits than fathers and daughters. Finally, horizontal traits were significantly more heritable between parents and daughters than sons.